This information encompassed the relationship with the child, marital status of the child’s parents, family structure, child’s age, identity of the primary family caregiver, physical health of both the child and the caregiver, method of the child’s conception, and feeding practices employed.

The Parenting Competence Scale was developed by Gibaud-Wallston and Wandersman [11] in 1978 and translated by Yang et al [12]. The scale comprises 17 items, bifurcated into two principal dimensions: efficacy and satisfaction. The efficacy component encompasses eight items that gauge parents’ self-perceptions of their parenting skills, whereas the satisfaction component comprises nine items that assess parents’ contentment with their role as caregivers. The scale ranged from “1: Totally Disagree” to “6: Totally Agree.” The scores fluctuate between 17 and 102, with elevated scores mirroring enhanced parenting competence. The reliability of the scale is substantiated by a Cronbach α coefficient of 0.80.

The Family Caregiver Specific QoL scale, developed by Nauser et al [13] and transcribed by Hyland Qian [14], was employed to assess the QoL in family caregivers. It comprised 16 items that span four dimensions: physical, social, spiritual, and psychological well-being. Four entries for each dimension. All domains carry equal importance. Employing a 5-point Likert scale, it allows respondents to answer with options ranging from “1: Strongly Disagree to “5: Strongly Agree.” Items that were negatively expressed were reverse-scored. The scale scores spanned from 16 to 80, with higher scores suggesting an enhanced QoL for the caregiver. The Cronbach α for the Chinese version of the scale was 0.84, further confirming its reliability and validity. This scale has been applied in family caregivers for children with heart disease, premature infants, and newborns [15,16].

Statistical analysis was conducted using SPSS software (version 24.0; IBM Corp). The general information was analyzed descriptively using frequency counts (component ratios). The QoL and parenting competence scores of family caregivers were characterized using means and standard deviations, provided they adhered to a normal distribution. One-way analyses were carried out to identify factors influencing QoL using t tests or ANOVA. The association between the QoL and parenting competence of family caregivers was assessed using the Pearson correlation analyses.

In this study, out of 291 participants, 278 were mothers (95.53%); therefore, mothers emerged as the predominant family caregivers. Consequently, efforts to enhance the QoL for family caregivers should prioritize understanding and addressing the experiences and sentiments of maternal caregivers. Out of 291 families, there are 170 nuclear families (58.4%) and 118 stem families (40.6%). Stem families refer to families where grandparents, parents, and children live together. This type of family is common. Although the mother is the primary caregiver, in China, grandparents are usually more involved in parenting. There may be differences in parenting concepts between parents and grandparents. Future research could explore the impact of grandparents’ involvement in parenting on family dynamics.

The mean (SD) parenting competence score among family caregivers of children aged 0‐3 years was 68.70 (9.816). This study is pioneering in investigating the parenting competence for this age group, as the majority of existing research has primarily concentrated on children age 1 years, particularly the initial 42 days postdelivery, thereby limiting comparative analysis [17]. The present study revealed a medium level of parenting competence. The efficacy and satisfaction dimensions had different numbers of entries and were not comparable.

In this study, the mean (SD) caregiver QoL score was found to be 56.81 (8.922). Given the plethora of scales designed to measure caregiver QoL, particularly those catered to children with special needs, direct comparisons with other studies are challenging [18]. Among the four dimensions assessed, family caregivers exhibited the highest scores in psychological well-being. Parent-child interactions appear to bolster parent-infant attachment, especially during early development stages (0‐3 y). Therefore, promoting these interactions within families could be an effective strategy for future interventions [19]. The social and psychological dimensions of QoL were notably deficient, so strengthening social support for caregivers of children aged 0 to 3 years and addressing their related psychological issues is a way to improve the QoL for caregivers [20].

Research has consistently demonstrated a positive correlation between parenting efficacy and the QoL of caregivers [21-23]. Enhanced parenting efficacy not only bolsters cognitive and behavioral functioning but also catalyzes improvements in physical and mental health. Alam et al [24] found that caregivers are susceptible to physiological issues such as sleep disorders, weight loss, and fatigue due to their caregiving responsibilities. According to Bandura’s theory [25], parents with a heightened sense of efficacy are more adept at self-regulation and self-management when confronted with challenging parenting scenarios, such as a decline in the child’s health, thereby enjoying a higher physiological QoL. In terms of mental aspects, the task of caregivers is to manage the daily needs of children aged 0 to 3 years, take care of family members, and participate in decision-making, which may lead to mental health challenges. The research implies that individuals possessing a stronger sense of efficacy may exhibit an enhanced ability to mitigate the detriments of negative mental health [26]. Confronted with obstacles in parenting, such as disputes concerning educational philosophies, they are inclined towards adopting positive coping tactics to regulate their emotional state and promote superior mental health quality. From a social perspective, an unwavering focus on infants and toddlers might curtail a carer’s independence, consequently posing adverse effects on their psychosocial development. Numerous investigations establish a linkage between social support and QoL [27-29]. Such findings indicate that the QoL could potentially intermediate the relationship between a collective sense of efficacy and parenting proficiency. In other words, caregivers possessing a stronger sense of efficacy are likely to be more assertive in pursuing social support, are more equipped to furnish social support, and possess a better overall social QoL. The psychological state of a caregiver is heavily influenced in their interaction with children aged 0‐3 years [30]. Factors such as concern for the child’s health, challenges in transitioning to caregiving roles, and understanding the child’s expressions may catalyze anxiety and depression among caregivers. Loh et al [31] proposed that caregivers who are capable of effectively managing, adjusting to, and surmounting difficulties experience lesser burden and exhibit fewer symptoms of anxiety and depression. Furthermore, these caregivers tend to have a better social QoL due to their increased sense of efficacy.

The positive correlation between childcare satisfaction and caregiver QoL has been well-documented. Numerous studies have examined the correlation between satisfaction and the QoL, typically comparing the two as indicators for assessing outcomes [32,33]. However, Sansó et al [34] postulated a direct correlation between life satisfaction and the QoL. Parenting satisfaction represents an individual’s comprehensive evaluation of their parenting role. Physiologically, parents experiencing high levels of satisfaction are less inclined to engage in self-reproach, exhibit reduced susceptibility to fatigue and burnout while attending to children aged 0‐3 years, and provide superior care, thereby enhancing their physiological QoL. Psychologically, these parents demonstrate a decreased likelihood of experiencing frustration and negative emotions when confronted with childcare challenges. Moreover, the subjective experience of well-being is recognized as a fundamental element for maintaining high mental health and satisfaction [35]. Consequently, parents who report satisfaction tend to exhibit a lower threshold for experiencing pleasure, reduced vulnerability to mental or psychological issues, and an elevated mental and psychological QoL. Socially, in line with societal expectations in many cultures, Chinese parents who fall short in their parenting duties are held accountable by various segments of society. Parents with high parenting satisfaction are more likely to cultivate higher-quality social connections, receive enhanced social support for their childcare responsibilities, and enjoy a superior quality of social life.